Effects of TPF-DM on Nutrient Indexes and Immune Function in Severe Traumatic Brain Injury Patients / 肠外与肠内营养

ABSTRACT

Objective:To investigate the effect of TPF-DM on blood glucose levels and immune function in severe traumatic brain injury (STBI) patients.Methods:We consecutively included 60 STBI patients who were randomly divided into control and experimental groups.The two groups of patients were treated with TPF and TPF-DM as the main energy supply,respectively.Total protein,albumin,prealbumin,procalcitonin (PCT),immunoglobulinM (IgM),immunoglobulinG (IgG),immunoglobulinA (IgA) and blood glucose of all patients were detected on day 1,7 and 14.Immune function related indicators,serum protein and blood glucose were statistically analyzed.Results In the first week,the mean blood glucose level and incidence of hypoglycemia were not significantly different between the two groups (P ＞ 0.05).However,the blood glucose variability (BGV) was significantly different (P ＜ 0.05).In the second week,both the blood glucose level and BGV were in normal range with no significant difference between two groups (P ＞ 0.05).At dayl,the total protein,albumin,prealbumin,IgM,IgG and IgA of all the patients were below the normal level,while the PCT was exact opposite,but with no significant difference between the two groups (P ＞ 0.05).At day7,PCT decreased compared to dayl in both the control and experimental groups,while the total protein,albumin,prealbumin,IgM,IgG and IgA increased,but the experimental group increased much more compare to the control group (P ＜ 0.05).At dayl4,all these indexes returned to normal levels with no significant difference between the two groups (P ＞ 0.05).Conclusion:TPF-DM is significantly better than TPF to control the blood glucose level.TPF-DM may have a positive effect on the control of early excessive inflammation and infection,and then improve the immune function.Yet the potential physiopathologic mechanism needs further study.